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10SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signatur <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Receive y(Prin Na C. Da of D livery <br /> or on the front if space permits. /' h V <br /> 1. Article Addressed to: s dress different from item 11 Ye <br /> o tni <br /> t delivery address below: ❑ No <br /> ANGELA ROGAN-fR ETAL <br /> O BOX <br /> L95 <br /> ODI CA 95241 AUG 0 2096 UNIT II-H <br /> IP/NTS/PUOIR/PKT EWRONUE TAL HEALTH <br /> RE 3650 E.ACAMPO RD.,AC PERK - <br /> il I IIIIII I'll('�II Ii I II II III II I I IIII I II'I II III 3. ype El nature <br /> Mail Express® <br /> ❑Adult utt Sig Signature El Registered MaiIT"" <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ertified Mail® Delivery <br /> 9590 9401 0056 5071 6130 56 ❑Certified Mail Restricted Delivery eturn Receipt for <br /> ❑Collect on Delivery erchandise <br /> 2. Article Number!Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature Confirmation- <br /> Mail ❑Signature Confirmation <br /> 7 015 0640 0007 1118 7581 Mail Restricted Delivery Restricted Delivery <br /> oo) <br /> PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />